The purpose of this application to seek funding for the renewal of the General Clinical Research Center (GCRC) at Case Western Reserve University (CWRU) School of Medicine. The main GCRC is located at University Hospitals of Cleveland with a satellite at MetroHealth Medical Center (MHMC). In 2002, the GCRC supported 166 protocols for 90 principal investigators representing multiple schools, departments and divisions of CWRU, the Department of Cell Biology at the Cleveland Clinic Foundation, and the Department of Nutrition and Exercise Physiology at Cleveland State University. As a research institute, CWRU's School of Medicine has maintained a tradition of national leadership, including claim to 12 Nobel laureates among its alumni (5) and faculty (7). There are 1,493 full time faculty in the medical school. In 2001, CWRU researchers were funded over $174,000,000 by NIH. These awards include major funding for research in cancer, AIDS, diabetes, cystic fibrosis, hypertension, TB, skin diseases, Alzheimer's disease, cartilage regeneration, airway diseases, neonatal and adult metabolism, functional electric stimulation, perinatal medicine, and genetics defects of various types among others. Fifty-seven CWRU researchers were awarded more than $1 million in NIH support in 2002. In 2002, CWRU ranked 16th among the nations 126 medical schools in NIH support. Fifteen of the school's departments ranked in the top 20 of the corresponding departments. Compared to the last five year renewal, there has been a 17% increase in the number of GCRC investigators and 81% increase in number of protocols utilizing the GCRC which resulted in a 97% increase in the number of publications (from 201). The major areas of research include: 1. Biochemical and molecular enhancement of cancer chemotherapy. 2. Electronic restoration of movement in spinal cord injury and stroke. 3. Molecular biology and treatment of cystic fibrosis. 4. Carbohydrate and protein metabolism in pregnancy. 5. Epidemiology, genetics, and pathophysiology of sleep-disordered breathing. 6. Pathophysiology and renal outcomes of human hypertension. 7. Factors affecting feto-placental growth and development. 8. Pathophysiology and treatment of HIV diseases.